20 May 2016

BPD poses a major public health impact, and this highlights the urgent need for a new treatment approach.

5.9% of Australians have BPD during their lifetime – equivalent to 236,000 Melbournians, and 6,370 City of Stonnington residents, at any one time. Within our local Alfred Health catchment area, approximately 4,000 people already seek care for BPD. Monash Alfred Psychiatry research centre (MAPrc), which is a part of the Alfred hospital, receives 3-4 new referrals for patients with BPD to their specialist clinic each week.

Affecting both men and women, BPD develops in adolescence and can result in severe consequences. A history of complex trauma is common, and BPD sufferers tend experience intense emotions and mood swings. Not being able to manage these emotions often results in issues in their relationships with others. As seen in Emma’s case, other features of the disorder include chronic self-harm and suicidal behaviours, cognitive disturbances, intense anger, and chronic feelings of emptiness. It can also include poor self-esteem, fear of abandonment, and transient stress-induced psychosis. Untreated, 10% of these people with BPD will complete suicide.

Treatment options for BPD are limited. Psychotherapy (e.g. dialectical behavior therapy, mentalisation) is expensive, and there is a disproportionately low number of expert health practitioners trained to deliver these therapies. Medications currently used also have very modest and inconsistent effects, and are associated with significant side effects of sedation, weight gain, dizziness, and increased anxiety.

Growing evidence has implicated the faulty transmission of signals in the brain as a potential cause for BPD symptoms. At MAPrc, our team of researchers have found a promising novel treatment for BPD that acts by blocking excess activity of a receptor in the brain, thereby ensuring optimal neurotransmission. This drug is well-tolerated, and is currently approved by the Therapeutics Goods Administration (TGA) for different indications. It is the novel use of this drug in treating the symptoms of BPD that is currently under investigation.

Our recent pilot study testing the efficacy of this medication showed very promising results. Thus, we are now looking for more community involvement to boost our number of participants in order to further establish the utility of this new treatment. Anyone aged 18-65 years with symptoms such as relationships that are intense and unstable, a changeable sense of self, difficulty controlling anger, feelings of emptiness, reactive mood swings, or urges to harm yourself, or with a primary diagnosis of BPD is invited to participate in this trial.